Angioplasty death rate at Crouse highest in state

Syracuse, NY - Crouse Hospital had the highest death rate in the state in 2006 for patients getting non-emergency angioplasty, an operation that reopens blocked heart vessels, according to reports by the state Health Department.

One of two reports released Friday shows 11 of 715 Crouse patients died within 30 days of the procedure. The hospital had a risk-adjusted mortality rate for non-emergency angioplasty of 1.88 percent.

By comparison, risk-adjusted death rates for this same procedure were .34 percent at University Hospital and .77 percent at St. Joseph's Hospital Health Center. The state average was .63 percent.

The rates are risk-adjusted to allow for fair comparisons of hospitals, some of which get higher volumes of sicker patients with more complications.

Dr. Ron Stahl, Crouse's chief medical officer, said the hospital is analyzing the data to determine why its numbers are so high. Some of the patients died from causes unrelated to angioplasty, but the report does not make that distinction, he said. The report attributes all deaths within 30 days of angioplasty to that procedure, even if there was a different cause of death.

"We're going to do chart reviews and drill down into the data," Stahl said. "It's our responsibility and goal to ensure the patients who arrive here with cardiac disease get the best care possible."

The report showed St. Joe's had one of the lowest death rates in the state between 2004 and 2006 among patients undergoing heart valve or combination heart valve-bypass surgery. St. Joe's risk-adjusted death rate was 3.88 percent, significantly lower than the state average of 5.83 percent. Only two of 39 hospitals in the state doing these operations had lower death rates than St. Joe's.

University's death rate for these same heart operations was 6.35 percent.

The report singled out two St. Joseph's heart surgeons -- Dr. Mehdi Marvasti and Dr. Ahmad Nazem -- for having significantly lower than average death rates. University and St. Joe's are the only Central New York hospitals that do open heart surgery. The report also showed former University heart surgeon Dr. Anthony Picone, who left University in 2006, had a significantly higher than average death rate.

Among doctors performing angioplasty, the report singled out Dr. Joseph Battaglia of Crouse and Dr. Hani Kozman of University Hospital for having significantly higher than average death rates.

Kozman's numbers were skewed because two of his patients died of cancer within 30 days of undergoing angioplasty, said Dr. Michael Iannuzzi, University's chief of medicine. Iannuzzi said Kozman's average was skewed because he handles a higher proportion of emergency cases and more patients who are in cardiac shock.

The Health Department said doctors should discuss the information in the report with their patients and colleagues.

"While these statistics are an important tool in making informed health care choices, individual treatment plans must be made by doctors and patients together after careful consideration of all pertinent factors," the report said.

The report said many factors can influence the outcome of cardiac procedures including the patient's health, the skill of the operating team and post-operative care.